Often during surgical procedures the surgeon cannot easily reach areas where surgical suturing must be done. In addition it is sometimes difficult to place a surgical knot when suturing because of body fluids which makes the surgical thread slippery and difficult to manipulate. For that reason, a surgical knot pusher is used.
Generally, present surgical knot pushers are comprised of a long shaft having a hook or a v-shaped element on the end for pushing a knot down the surgical thread. These surgical knots are used in places and areas where because of the particular type of surgery, the surgeon may not be able to get his hands or the area is difficult to reach. Places such as bleeders that have been clamped off, are prime targets for use with a surgical knot pusher. The knot is first tied loosely and then pushed down the surgical thread to the site to tie off the particular area being sutured.
A frequent problem with present surgical knot pushers is that the thread slips off the tool during placement of the knot. The fine surgical thread is difficult to handle and is made all the more difficult when made slippery from body fluids. When trying to place a surgical knot it can cause great frustration and anxiety when the thread keeps slipping off the tool while trying to tie the surgical knot. It can be detrimental to the patient for a surgeon to experience such frustration during delicate surgical procedures.
Surgical knot pushers are also useful to increase the efficiency of surgical procedures so that the patient is not kept under anesthesia too long. They are particularly useful in laparoscopic surgery, in which only small incisions are made to reach the area being treated. The area being treated is viewed through a laparoscope while surgical instruments are manipulated through one or two other small incisions. Thus, of course, the area being treated is inaccessible to the surgeon except by use of instruments. There are two ways of tying a knot in a suture during laparoscopic surgery. One way is to tie the knot intra-abdominally or inside the body through instruments and the other is extra-abdominally or outside the body. In the first case, tying the knot is a very delicate procedure requiring lots of experience from the surgeon. There are instruments that somewhat simplify knot tying, but the knot still must be tied using twelve to fourteen inch long instruments while viewing the area on a two dimensional monitor, which is very difficult. In cases when the surgical knot is tied outside the abdomen or body the knot must then be pushed down through a guide tube called a cannula into an abdominal cavity with a tool, such as a knot pusher.
When incisions are made with a special tool called a trocar the sugery is performed through a guide tube called a cannula left in the incision. The trocar is removed and surgical instruments are introduced through a cannula of five, seven or up to ten mm (millimeters). Depending upon the procedure, four to five or more instruments may be used during the surgery. When suturing the surgeon passes the suture and needle through the cannula into the abdomen, sews, brings the end of the suture up through the cannula so that both ends are outside the body, ties the knot and pushes it down through the cannula with a knot pusher.
It would be advantageous if a surgical knot pusher can be provided that would increase the efficiency and ease with which the surgical knots can be placed.
It is therefore one object of the present invention to provide a surgical knot pushing tool that is simple and easy to use.
Yet another object of the present invention is to provide a surgical knot pushing appliance that is reliable and will prevent the knot from easily slipping out of the tool.
Still another object of the present invention is to provide a surgical knot pushing tool having a tip allowing the surgical thread and knot to be easily threaded for use.